408 ANTHRAX 



than a year, when a reinoculation is necessary. The method is 

 not free from objections, but its use in regions of France where 

 anthrax was very prevalent proved of enormous value, and areas 

 in which raising cattle and sheep was rapidly becoming im- 

 possible were practically cleared of the disease. The weak point 

 of the process is that the immunity to infection through the 

 alimentary canal, if it exists, is extremely feeble. 



To remedy the defects of Pasteur's system, Sobernheim has 

 introduced a method of conferring mixed immunity. An anti- 

 anthrax serum and a culture resembling Pasteur's second vaccine 

 are injected simultaneously into different parts of the body, and 

 no second inoculation is given. The doses are 5 to 15 c.c. of the 

 serum and 0-5 to i c.c. of culture. This method of treatment is 

 said to be free from danger, to protect against infection via the 

 intestinal tract ; it has also the advantage of requiring only a 

 single visit. The serum is also curative. 



Curative Treatment. Here the use of serum is indicated. Sclavo's 

 serum is most used in this country. It is obtained by immuniz- 

 ing the animals with Pasteur's vaccines, and then by giving large 

 doses of virulent bacilli mixed with gelatin, which seems to 

 prevent the formation of abscesses. The dose is 20 to 40 c.c., 

 repeated in twenty-four hours if necessary, or four or five doses 

 of 20 c.c. each : the first injection may advantageously be 

 intravenous. It is usually followed by improvement within 

 twenty-four hours, and often causes sweating and a rise of 

 temperature. Sobernheim's serum is obtained by a somewhat 

 different method, and appears to be equally efficacious. The dose 

 recommended is 20 c.c. 



The results of the use of serum in malignant pustule (which is 

 not so dangerous a disease as was once thought, even if untreated 

 by serum, the knife, cautery, etc.) have been very satisfactory: 

 there do not seem to be any observations on its use in the 

 far more serious woolsorter's disease or pulmonary anthrax. 

 Malignant pustule is also treated by the use of very hot fomenta- 

 tions, the idea being to bring about the attenuation of the bacillus. 

 There is little doubt that vaccines might be used if thought 

 desirable in the absence of serum. 



Diphtheria. 



Diphtheria presents a close approach to our idea of a disease the 

 immunity to which is antitoxic, but it is erroneous to imagine that 



